Benign Leukocytoses -Krafts

Question 1

Neutrophils live where?

Answer 1

Most neutrophils are in BM (5% in blood)

The ones in blood, 1/2 are marginated in walls of blood vessels.

Question 2

Mature Neutrophilia

Answer 2

-Lots of SEGMENTED neutrophils

Question 3

Immature Neutrophilia

Answer 3

-Lots of IMMATURE neutrophils (bands, metamyelocytes..)

Question 4

Causes of Mature Neutrophilia?

Answer 4

• Bacterial infection
• Inflammation
• Physiologic things (stress, hormones)

Question 5

Toxic changes in neutrophils

-mature and immature neutrophilias

Answer 5

-ONLY seen in infections (good indicators)
3 types: 
-Toxic granulation (dark purple)
-Dohle bodies (RER in cytoplasm)
-cytoplasmic vacuolization (scariest)

Question 6

Toxic Granulation

Answer 6

-indicates more rapid maturation of neutrophils

Question 7

Cytoplasmic Vacuolization

Answer 7

Indicator of VERY SEVERE infection.

-this should freak you out.

Question 8

Causes of Immature Neutrophilia:

Answer 8

• Bacterial infection
• Inflammation
• Severe anemia
• Something filling up the marrow– kicks neutrophils out.

Question 9

3 forms of immature Neutrophilia

Answer 9

1. Left shift: Neutrophil count shifts to more early precursors (immature)
2. Leukemoid Reaction
3. Leukoerythroblastotic reaction: see left shift of WBC and young, nucleated RBCs.

Question 10

Leukoerythroblastotic reaction: Why?

Answer 10

Can be because of something malignant or benign

-really bad anemia (BM is rushed trying to get RBC out into periphery) ==Benign

Something filling up BM ==Malignant

• look at Hbg to distinguish the two

Question 11

Lymphocytes

Know % of T, B and NK cells.

Answer 11

Lots =viral infection probably

Lymphocyte count varies w/ age. Higher in babies.

**KNOW :
T-cells: 80%
B cells: 15%
NK cells: 5%

Question 12

Mature Lymphocytosis

Causes: only 3

Answer 12

-Lots of mature lymphocytes

• Infectious lymphocytosis (viral infection in kids)
• Bordetella pertussis
• Transient stress

Question 13

Reactive Lymphocytosis

Answer 13

-lots of funny-looking lymphocytes

Question 14

What causes the biggest mature lymphocytosis?

Answer 14

Infectious lymphocytosis!

Question 15

Causes of Reactive lymphocytosis

Answer 15

• Infectious mononucleosis (Downey cells)
• Pediatric viral infections
• Viral hepatitis
• Immune disorders

Question 16

Different cells in reactive lymphocytosis

Answer 16

• Downey cells –> mono

- Plasmacytoid lymphocyte

Question 17

Left shift characteristics:

Answer 17

• toxic changes
• fewer immature cells
• NO BASOPHILIA
• LAP normal/increased (leukocyte alkaline phosphatase)

Question 18

CML characteristics:

Answer 18

• Super high WBC
• Lots of immature cells
• basophilia
• LAP decreased

Question 19

Best way to differentiate benign neutrophilia from CML?

Answer 19

Cytogenetics!

Question 20

Reactive Lymphocytosis vs. CLL vs Mature lymphocytosis

Answer 20

Reactive: atypical lymphocytes, young 40

CLL: mature lymphocytes, monomorphous, OLDER >40

Mature lymphocytosis: mature lymphocytes, VER YOUNG

Question 21

Best way to differentiate behign lymphocytosis from CLL?

Answer 21

Immunophenotyping

CLL is in B cells

Question 22

Basophilia causes:

Answer 22

ONLY in CML (chronic myeloid leukemia)

Question 23

Eosinophilia causes?

Answer 23

• Drugs
• Asthma
• Skin diseases (allergic ones)
• Parasites

Question 24

Monocytosis causes?

Answer 24

• Infection
• Autoimmune disease
• Malignancy